Research Alert: July 22, 2025
Interstate Occupational Licensure Arrangements to Expand Access to Behavioral Health Services
This policy brief describes state-based provisions to expand behavioral health services through interstate licensure arrangements for psychologists, social workers, licensed professional counselors, marriage and family therapists, and school psychologists, including licensure compact agreements and licensure portability models.
Key Findings:
- Interstate licensure arrangements for behavioral health providers are in the early stages of development and utilization. As of November 2024, interstate licensure arrangements for psychologists, social workers, licensed professional counselors, marriage and family therapists, and school psychologists ranged from early stage development to occupational compacts that have recently become operational for selected services.
- Future research and evaluation will be needed to understand the degree to which behavioral health providers utilize interstate licensing arrangements and their impact on cost, access, and quality of behavioral health services.
- Telehealth is currently the most established method for patients to access behavioral health services from out-of-state providers. Some states have passed permanent legislation allowing out-of-state behavioral health providers to provide telehealth services to in-state patients. These regulations may enhance access to behavioral health services for rural patients.
Natalia Oster, PhD, MPH
WWAMI Rural Health Research Center
nvoster@uw.edu
Additional Resources of Interest:
- Federal and State Reimbursement for Youth Behavioral Health Services
- More FORHP-funded research on Mental and behavioral health
- More information about the WWAMI Rural Health Research Center
- More information from the Rural Health Information Hub's topic guide: Mental Health